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3. Healthcare Costs and Resource Utilisation of Italian Metastatic Non-Small Cell Lung Cancer Patients

Author

Gentili, Nicola, primary, Balzi, William, additional, Foca, Flavia, additional, Danesi, Valentina, additional, Altini, Mattia, additional, Delmonte, Angelo, additional, Bronte, Giuseppe, additional, Crinò, Lucio, additional, De Luigi, Nicoletta, additional, Mariotti, Marita, additional, Verlicchi, Alberto, additional, Burgio, Marco Angelo, additional, Roncadori, Andrea, additional, Burke, Thomas, additional, and Massa, Ilaria, additional

Published
2024
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5. European value-based healthcare benchmarking: moving from theory to practice.

Author

García-Lorenzo, Borja, Gorostiza, Ania, Alayo, Itxaso, Zas, Susana Castelo, Baena, Patricia Cobos, Camiña, Inés Gallego, Narbaiza, Begoña Izaguirre, Mallabiabarrena, Gaizka, Ustarroz-Aguirre, Iker, Rigabert, Alina, Balzi, William, Maltoni, Roberta, Massa, Ilaria, López, Isabel Álvarez, Lobera, Sara Arévalo, Esteban, Mónica, Calleja, Marta Fernández, Mediavilla, Jenifer Gómez, Fernández, Manuela, and Hitar, Manuel del Oro

Subjects
RESEARCH, STATISTICAL significance, HEALTH facilities, HUMAN research subjects, KEY performance indicators (Management), LUNG tumors, HEALTH outcome assessment, MEDICAL care costs, REGRESSION analysis, VALUE-based healthcare, BENCHMARKING (Management), INFORMED consent (Medical law), QUESTIONNAIRES, CLINICAL medicine, DESCRIPTIVE statistics, RESEARCH funding, SOCIODEMOGRAPHIC factors, ELECTRONIC health records, CLUSTER analysis (Statistics), BREAST tumors, LONGITUDINAL method, DELPHI method
Abstract

Background Value-based healthcare (VBHC) is a conceptual framework to improve the value of healthcare by health, care-process and economic outcomes. Benchmarking should provide useful information to identify best practices and therefore a good instrument to improve quality across healthcare organizations. This paper aims to provide a proof-of-concept of the feasibility of an international VBHC benchmarking in breast cancer, with the ultimate aim of being used to share best practices with a data-driven approach among healthcare organizations from different health systems. Methods In the VOICE community—a European healthcare centre cluster intending to address VBHC from theory to practice—information on patient-reported, clinical-related, care-process-related and economic-related outcomes were collected. Patient archetypes were identified using clustering techniques and an indicator set following a modified Delphi was defined. Benchmarking was performed using regression models controlling for patient archetypes and socio-demographic characteristics. Results Six hundred and ninety patients from six healthcare centres were included. A set of 50 health, care-process and economic indicators was distilled for benchmarking. Statistically significant differences across sites have been found in most health outcomes, half of the care-process indicators, and all economic indicators, allowing for identifying the best and worst performers. Conclusions To the best of our knowledge, this is the first international experience providing evidence to be used with VBHC benchmarking intention. Differences in indicators across healthcare centres should be used to identify best practices and improve healthcare quality following further research. Applied methods might help to move forward with VBHC benchmarking in other medical conditions. [ABSTRACT FROM AUTHOR]

Published
2024
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7. Real-World Outcomes and Treatments Patterns Prior and after the Introduction of First-Line Immunotherapy for the Treatment of Metastatic Non-Small Cell Lung Cancer

Author

Danesi, Valentina, primary, Massa, Ilaria, additional, Foca, Flavia, additional, Delmonte, Angelo, additional, Crinò, Lucio, additional, Bronte, Giuseppe, additional, Ragonesi, Maria, additional, Maltoni, Roberta, additional, Manunta, Silvia, additional, Cravero, Paola, additional, Andrikou, Kalliopi, additional, Priano, Ilaria, additional, Balzi, William, additional, Gentili, Nicola, additional, Burke, Thomas, additional, and Altini, Mattia, additional

Published
2022
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8. Abstract P2-13-44: HDAC6 is an unfavorable prognostic factor in HER2-positive breast cancer patients treated with adjuvant trastuzumab

Author

Ravaioli, Sara, primary, Maltoni, Roberta, additional, Petracci, Elisabetta, additional, Palleschi, Michela, additional, Balzi, William, additional, Pirini, Francesca, additional, Tumedei, Maria Maddalena, additional, Zanoni, Michele, additional, Cortesi, Michela, additional, Martinelli, Giovanni, additional, Rocca, Andrea, additional, and Bravaccini, Sara, additional

Published
2022
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9. Appropriateness and Economic Analysis of Conventional Circulating Biomarkers Assessment in Early Breast Cancer: A Real-World Experience from the E.Pic.A Study

Author

Maltoni, Roberta, primary, Balzi, William, additional, Rossi, Tania, additional, Fabbri, Francesco, additional, Bravaccini, Sara, additional, Montella, Maria Teresa, additional, Massa, Ilaria, additional, Bertoni, Lucia, additional, Falcini, Fabio, additional, and Altini, Mattia, additional

Published
2022
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12. How to discriminate non-small cell lung cancer (NSCLC) cases from an Italian administrative database? A retrospective, secondary data use study for evaluating a novel algorithm performance

Author

Balzi, William, primary, Roncadori, Andrea, additional, Danesi, Valentina, additional, Massa, Ilaria, additional, Manunta, Silvia, additional, Gentili, Nicola, additional, Delmonte, Angelo, additional, Crinò, Lucio, additional, and Altini, Mattia, additional

Published
2021
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14. Tamoxifen protects breast cancer patients from COVID-19: first evidence from real world data

Author

Bravaccini, Sara, primary, Nicolini, Fabio, additional, Balzi, William, additional, Azzali, Irene, additional, Calistri, Arianna, additional, Parolin, Cristina, additional, Vitiello, Adriana, additional, Biasolo, Maria Angela, additional, Mazzotti, Lucia, additional, Gaimari, Anna, additional, Maltoni, Roberta, additional, Altini, Mattia, additional, Falcini, Fabio, additional, Montella, Maria Teresa, additional, Nanni, Oriana, additional, Ravaioli, Sara, additional, Pirini, Francesca, additional, Tumedei, Maria Maddalena, additional, Cortesi, Michela, additional, Zanoni, Michele, additional, Cerchione, Claudio, additional, Sambri, Vittorio, additional, Ibrahim, Toni, additional, Martinelli, Giovanni, additional, and Mazza, Massimiliano, additional

Published
2021
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15. Emilia-Romagna Surgical Colorectal Cancer Audit (ESCA): a value-based healthcare retro-prospective study to measure and improve the quality of surgical care in colorectal cancer.

Author

Massa, Ilaria, Ghignone, Federico, Ugolini, Giampaolo, Ercolani, Giorgio, Montroni, Isacco, Capelli, Patrizio, Garulli, Gianluca, Catena, Fausto, Lucchi, Andrea, Ansaloni, Luca, Gentili, Nicola, Danesi, Valentina, Montella, Maria Teresa, Altini, Mattia, The ESCA Collaborative Group, Balzi, William, Roncadori, Andrea, Ferri, Giacomo, Gallo, Simona, and Di Genova, Giuseppa

Subjects
COLORECTAL cancer, VALUE-based healthcare, CANCER treatment, PROCTOLOGY, PERIOPERATIVE care
Abstract

Purpose: Surgery is the main treatment for non-metastatic colorectal cancer. Despite huge improvements in perioperative care, colorectal surgery is still associated with a significant burden of postoperative complications and ultimately costs for healthcare organizations. Systematic clinical auditing activity has already proven to be effective in measuring and improving clinical outcomes, and for this reason, we decided to evaluate its impact in a large area of northern Italy. Methods: The Emilia-Romagna Surgical Colorectal Audit (ESCA) is an observational, multicentric, retro-prospective study, carried out by 7 hospitals located in the Emilia-Romagna region. All consecutive patients undergoing surgery for colorectal cancer during a 54-month study period will be enrolled. Data regarding baseline conditions, preoperative diagnostic work-up, surgery and postoperative course will be collected in a dedicated case report form. Primary outcomes regard postoperative complications and mortality. Secondary outcomes include each center's adherence to the auditing (enrolment rate) and evaluation of the systematic feedback activity on key performance indicators for the entire perioperative process. Conclusion: This protocol describes the methodology of the Emilia-Romagna Surgical Colorectal Audit. The study will provide real-world clinical data essential for benchmarking and feedback activity, to positively impact outcomes and ultimately to improve the entire healthcare process of patients undergoing colorectal cancer surgery. Clinical trial registration: The study ESCA is registered on the clinicaltrials.gov platform (Identifier: NCT03982641). [ABSTRACT FROM AUTHOR]

Published
2022
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22. Performance indicators for monitoring the integrated care pathway of patients with colorectal cancer: the E.Pic.A. project: Performance indicators for colorectal cancer

Author

Ricotti, Andrea, Messori Ioli, Giovanni, Altini, Mattia, Bachini, Letizia, Balzi, William, Frassineti, Giovanni Luca, Gemmi, Fabrizio, Massa, Ilaria, Pierini, Andrea, Bertetto, Oscar, Racca, Patrizia, Ricotti, Andrea, Messori Ioli, Giovanni, Altini, Mattia, Bachini, Letizia, Balzi, William, Frassineti, Giovanni Luca, Gemmi, Fabrizio, Massa, Ilaria, Pierini, Andrea, Bertetto, Oscar, and Racca, Patrizia

Abstract

Background: Given limitations in economic resources, achieving sustainability in healthcare is an increasingly important issue driving policy decisions. Colorectal cancer (CRC) is a frequent oncological diagnosis with an incidence that is expected to increase, making the efficient utilisation of resources a major priority for its diagnosis and treatment. To assess potentially inappropriate utilisation of services in the integrated care pathway of patients with malignant CRC, a series of key performance indicators (KPIs) have been developed by a multidisciplinary panel of the E.Pic.A. project (Economic Appropriateness of an Integrated Care Pathway).Methods: The KPIs identified had to comply with criteria of reliability, representativeness, accessibility and operativity. A definition is provided for each of the KPIs, along with the methodology used to calculate it and a reference target.Results: Eight KPIs were identified that can measure inadequacies of services provided in the diagnostic and treatment pathways for CRC: four for instrumental diagnostics, three for surgery and one for oncologic therapy.Conclusions: Use of the methodology described can help payors to obtain detailed information on inappropriate and wasteful use of healthcare resources, which would then permit their reallocation for interventions with higher value for patients with CRC and other pathologies. (HTA & Market Access, Oncology)

Published
2019

23. Key performance indicators for monitoring the integrated care pathway in breast cancer: the E.Pic.A. project

Author

Altini, Mattia, Balzi, William, Maltoni, Roberta, Falcini, Fabio, Foca, Flavia, Messori Ioli, Giovanni, Ricotti, Andrea, Bertetto, Oscar, Mistrangelo, Marinella, Amunni, Gianni, Gemmi, Fabrizio, Bachini, Letizia, Silenzi, Andrea, Pastorino, Roberta, Barbara, Andrea, Pierini, Andrea, Massa, Ilaria, Altini, Mattia, Balzi, William, Maltoni, Roberta, Falcini, Fabio, Foca, Flavia, Messori Ioli, Giovanni, Ricotti, Andrea, Bertetto, Oscar, Mistrangelo, Marinella, Amunni, Gianni, Gemmi, Fabrizio, Bachini, Letizia, Silenzi, Andrea, Pastorino, Roberta, Barbara, Andrea, Pierini, Andrea, and Massa, Ilaria

Abstract

Background: Due to its high incidence, evaluating performance of care delivered to breast cancer patients is a crucial issue. The multidisciplinary panel E.Pic.A. (Economic Appropriateness of an Integrated Care Pathway) defined a set of key performance indicators (KPIs) to evaluate economic waste in breast cancer healthcare interventions. Methods: The E.Pic.A. panel identified the principal KPIs that are crucial within the breast cancer care pathway to evaluate the performance of care. KPIs were defined taking into account their reliability, validity, usability and feasibility of measurement through the linkage between multiple routine healthcare data sources. Results: Seven KPIs were identified: three on instrumental diagnostics, two on surgery and two on treatment. The three KPIs regarding instrumental diagnostics are aimed at assessing the inappropriateness of diagnostic tests performed before and after the index surgery. The two KPIs regarding surgery measure the inappropriateness of possible repeated interventions considering the time elapsed from the index surgery. The two KPIs regarding oncologic therapy measure the inappropriateness about the administration time of adjuvant therapy and radiotherapy considering the time elapsed from the index surgery. Conclusion: E.Pic.A methodology could help to evaluate economic waste in healthcare interventions with the objective of redirecting resources to interventions with greater value. (HTA & Market Access)

Published
2019

24. The challenge of sustainability in healthcare systems: economic and organizational impact of subcutaneous formulations for rituximab and trastuzumab in onco-hematology.

Author

Altini, Mattia, Gentili, Nicola, Balzi, William, Musuraca, Gerado, Maltoni, Roberta, Masini, Carla, Galardi, Francesca, Bertoni, Lucia, and Massa, Ilaria

Subjects
PILOT projects, RESEARCH, INTRAVENOUS therapy, TIME, RESEARCH methodology, CELL receptors, MEDICAL care, RETROSPECTIVE studies, MEDICAL care costs, MEDICAL cooperation, EVALUATION research, COMPARATIVE studies, LYMPHOMAS, BREAST tumors, SUBCUTANEOUS injections
Abstract

Background: This study estimated the economic and organisational impact of using subcutaneous injection (SC) formulations of two monoclonal antibodies (rituximab and trastuzumab) in patients with non-Hodgkin's lymphoma (NHL) and HER2 + breast cancer (BC).Methods: The database of the Unit of Oncology and Haematology of the IRST of Meldola was used. The analysis was structured as follows: i) measurement of the volume of Day-Hospital activity; ii) identification of activities and time to complete the administration; iii) estimate the mean cost of an SC or IV (intravenous infusion); iv) estimate the impact of SC formulations on the volumes of activities provided; v) estimate the social impact of SC or IV formulations.Results: The use of an SC formulation was associated a significant reduction in the time that the patient takes to complete the administration (trastuzumab -1 hr 18 min; rituximab -2 hr 24 min) and in consumption of healthcare resources and related costs for trastuzumab (IV: € 1781; SC: € 1701) and rituximab (IV: € 2116; SC: € 1941).Conclusion: The adoption of the SC formulation for rituximab and trastuzumab can generate a greater value for both the national healthcare system and the patient compared to an IV formulation. [ABSTRACT FROM AUTHOR]

Published
2021
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26. Performance indicators for monitoring the integrated care pathway of patients with colorectal cancer: the E.Pic.A. project

Author

Ricotti, Andrea, primary, Messori Ioli, Giovanni, additional, Altini, Mattia, additional, Bachini, Letizia, additional, Balzi, William, additional, Frassineti, Giovanni Luca, additional, Gemmi, Fabrizio, additional, Massa, Ilaria, additional, Pierini, Andrea, additional, Bertetto, Oscar, additional, and Racca, Patrizia, additional

Published
2019
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27. Key performance indicators for monitoring the integrated care pathway in breast cancer: the E.Pic.A. project

Author

Altini, Mattia, primary, Balzi, William, additional, Maltoni, Roberta, additional, Falcini, Fabio, additional, Foca, Flavia, additional, Messori Ioli, Giovanni, additional, Ricotti, Andrea, additional, Bertetto, Oscar, additional, Mistrangelo, Marinella, additional, Amunni, Gianni, additional, Gemmi, Fabrizio, additional, Bachini, Letizia, additional, Silenzi, Andrea, additional, Pastorino, Roberta, additional, Barbara, Andrea, additional, Pierini, Andrea, additional, and Massa, Ilaria, additional

Published
2019
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30. Are BMI and Negative Hormone Receptors Prognostic Factors in HER2+ Early-stage Breast Cancer?

Author

William Balzi, Sara Bravaccini, Mattia Altini, Michela Palleschi, Ilaria Massa, Sara Ravaioli, Maria Maddalena Tumedei, Andrea Rocca, Roberta Maltoni, Maltoni, Roberta, Palleschi, Michela, Altini, Mattia, Massa, Ilaria, Balzi, William, Ravaioli, Sara, Tumedei, Maria Maddalena, Rocca, Andrea, and Bravaccini, Sara

Subjects
Oncology, Cancer Research, medicine.medical_specialty, business.industry, Early breast cancer, adjuvant therapy, body mass index, medicine.disease, HER2-positive, estrogen receptor, trastuzumab, Breast cancer, Hormone receptor, Internal medicine, medicine, Stage (cooking), business
Abstract

N/A

Published
2020

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